the history, current status, and future prospects of barefoot doctors in china china rural health...

The History, Current Status, and The History, Current Status, and Future Prospects of Barefoot Future Prospects of Barefoot

Doctors in ChinaDoctors in China

China Rural Health AssociationChina Rural Health Association

Dr. Wang Shucheng

Author synopsisAuthor synopsis

Education experience:Education experience: March 1978 - In 1982, student of Bethune March 1978 - In 1982, student of Bethune

Medical University in Changchun City of Medical University in Changchun City of clinical studyclinical study

1988 - 1990 San Diego State University of 1988 - 1990 San Diego State University of United StatesUnited States

Work experience:Work experience: In 1983 - 1999 Head of PHC Division in In 1983 - 1999 Head of PHC Division in

Ministry of HealthMinistry of Health 2000 – present China Deputy Director of 2000 – present China Deputy Director of

Rural HealthRural Health Association

The definition of barefoot doctorsThe definition of barefoot doctors

The main contents of the reportThe main contents of the report

Formation and Development of Barefoot Doctors in China

Current Situation

The Future of Village Doctors in China

Case study

Experience


First stage － 1949 to 1965



Second stage － 1966 to 1978



Second stage － 1966 to 1978

Third stage － 1978 to present

Current Situation

Current Situation

Village Doctors and Clinics in China

Table1: Number of Village Clinics and Their Health Workers

1985 1990 1995 2000 2005

(1) Number of Villages 940617 743278 740150 734715 652718

(2) Villages with Clinic 625992 646529 655105 652923 583209

% ((2)/(1)) 66.6 87.0 88.5 89.8 83.7

Number of Village Clinics 777674 803956 804352 709458 583209

Set-up by villages 305537 266137 297462 300846 313633

Joint-venture 8803 87149 90681 89828 38561

Branch of Township Health Center 29769 29963 36388 47101 32396

Private 323904 381844 354981 255179 180403

Others 29661 38863 24840 16486 18216

Licensed Assistant Doctors —— —— —— —— 103863

Village Doctors& Assistants 1293094 1231510 1331017 1319359 916532

of which： Village Doctors 643022 776859 955933 1019845 864168

Village Doctors& Assistants Per village

1.80 1.64 1.81 1.81 1.40

Village Doctors& Assistants Per 1000 Rural Population

1.55 1.38 1.48 1.44 1.05

Note: （ 1 ） Number of Villages means number of villager committees. （ 2 ） 2005 agriculture population is estimated.

Table 2: No. of Village Clinics and Their Health

Workers by Region in 2006 Region No. of Village No. of Village Clinics % of Villages with

Clinic Village Doctors & Assistants

Total 624680 609128 88.1 957479

East 238577 211297 79.5 328778

Middle 202488 212235 92.9 349354

West 183615 185596 94.0 279347

Beijing 3957 2762 69.8 4019

Tianjing 3825 2380 62.2 5178

Heibei 49115 52907 100.0 73038

Shanxi 28172 22123 78.5 46318

Inner Mongolia

11219 13066 100.0 17731

Liaoning 11768 21345 100.0 25854

Jilin 9211 8594 93.3 13188

Heilongjiang 9055 12548 100.0 22482




Shanghai 1862 1642 88.2 1919

Jiangsu 17303 12656 73.1 36720

Zhejiang 32931 16438 49.9 15561

Anhui 20019 22372 100.0 46271

Fujian 14485 17470 100.0 29452

Jiangxi 17571 22089 100.0 35280

Shandong 81283 56779 69.9 101813

Henan 48362 61336 100.0 104788

Hubei 25828 24226 93.8 41200

Hunan 44270 38227 86.3 39827

Guangdong 19505 24810 100.0 32753

Guangxi 14363 22367 100.0 35407




Hainan 2543 2108 82.9 2471

Chongqing 9722 10539 100.0 21299

Sichuan 50299 51247 100.0 73707

Guizhou 19669 19660 100.0 26072

Yunan 12882 13608 100.0 35478

Tibet 5746 3473 60.4 3167

Shaanxi 27537 25280 91.8 32679

Gansu 16823 13781 81.9 17448

Qinghai 4163 4180 100.0 4804

Ningxia 2376 2793 100.0 4149

Xinjiang 8816 5332 60.5 7406

Current Situation


Preparation and Qualification of Village Health Workers

Current Situation



Responsibilities and Tasks of Village Health Workers

Current Situation




Infrastructure of Village Clinics

Current Situation




Infrastructure of Village Clinics

Management of Village Clinics


Policy Supports


Policy Supports

Financial Supports


Policy Supports

Financial Supports

Education and Technical Support

Case study——Village Clinics in Shenyang City

Shenyang city has 8 counties and districts (rural areas) with 1932 villages. In 2001, we randomly selected and surveyed 66 villages at different economic levels. There were 26,460 households in these villages, an average of 401 households with 1,436 persons per village. Total population was 94,754 at these villages. Annual per capita income for peasants in 2001 was 2,637 RMB. There were 123 village clinics at these villages, 1.68 per village, a lower density than the average in the province of 1.74 but higher than that of the country of 0.98. The average room space of each village clinics was 46.83 square meter. Capital asserts per village clinic was 7,480 RMB. There were 135 village doctors, 2.05 per village, much higher than that of province and country. 80 village doctors were trained in the past 2 years. The cumulative training time for each doctor was 3.5 months. On average, each doctor served 734 patients. The survey showed that when residents became sick, 76.67 percent of residents went to village clinics, 14.63 percent to township health centers, and 1.6 percent to county hospitals and above.

Experience

Experience As the social-economic condition is still under-developed in rural As the social-economic condition is still under-developed in rural

area, government and the people should pay more attention to rurarea, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limal health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workerited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation.s—village doctors, who are suitable to rural situation.



Governments should provide funds and teachers for village doctoGovernments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could rs’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents.meet the increasing medical needs of village residents.




In China, township health centers and village clinics are nonprofit In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would mhealth organizations. Keeping their public characteristics would maximally protect health right of peasants.aximally protect health right of peasants.





Village doctors should be supervised and monitored in order to imVillage doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abprove their professional competency and prevent wastage and abuse of drugs and supplies.use of drugs and supplies.





Village doctors should be supervised and monitored in order to imVillage doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abprove their professional competency and prevent wastage and abuse of drugs and supplies.use of drugs and supplies.

Village doctors could fulfill their responsibility in disease preventiVillage doctors could fulfill their responsibility in disease prevention and control by making fuller use of villager committee to carry on and control by making fuller use of villager committee to carry out the health education and promotion programs.out the health education and promotion programs.

the history, current status, and future prospects of barefoot doctors in china china rural health...

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